Borrowing Provider Numbers Can Bring Big Trouble

Borrowing Provider Numbers Can Bring Big Trouble

When performing medical billing, using your own provider number is a requirement. Failure to do so is considered fraud and is not tolerated. Using another provider’s tax identification number for medical billing can cost you big money and even jail time.

Fraud costs Americans billions of dollars a year. (yes I said BILLIONS). One of the may variations of medical insurance fraud is using another provider’s Tax identification number. There are several reasons why providers would want to do this. A doctor without a contract with a provider network may want to use a TIN of a provider inside that network. Some people may use a doctor’s tax I.D. number for medical billing because they, themselves are not actual licensed medical professionals. There are many reasons people become dishonest in medical billing.

Recently in Midland, TX, a cardiologist named Piyush Patel got in trouble with the law. He had pled guilty to a 2002 felony and wasn’t allowed to bill Medicare for three years. He, greedily, did not want to lose Medicare revenue for a three year period, so he falsely used his wife’s TIN for medical billing. He has been punished. Not only must he repay all $660,000, but he also has to serve 21 months in jail for breaking the law. After his release, Medicare will supervise him for three years.

Breaking medical billing laws is not worth the immediate gratification of money you will receive. Eventually you will get caught and have to pay back every last penny you stole. You will serve jail time and be a criminal with a permanent record. If there is ever a question of legality in your mind, always error on the safe side. You do not want to become a medical billing criminal due to one stupid decision.

View all Articles by: Melissa Clark, CCS-P